Question 1

A patient is prescribed to receive 2 units of packed red blood cells.What approach should the nurse use to ensure that the correct blood will be provided to this patient?

Accepted Answer

Before initiating a blood or blood component transfusion,the blood should be matched with the order,matched with the patient,verified using a two-person or one-person process with bar coding,and verified according to the organization's verification process.A.B.More than the patient arm band and order need to be checked.D.The nurse should never assume that the blood bank has provided the correct blood for a patient.

Question 2

A patient has a bone marrow aspiration from the posterior iliac crest.Before the procedure,the patient's vital signs were: blood pressure 132/82 mm Hg and pulse 88 beats/min.One hour after the procedure,the blood pressure is 108/70 mm Hg and pulse is 96 beats/min.Which assessment is the least important for the patient at this time?

Accepted Answer

The most recent blood count is not immediately helpful unless it is used to compare with a new,post-biopsy report.A.C.D.The vital signs indicate a change in status following the biopsy-possible causes include bleeding from the site or a medication response.Symptoms of low blood pressure include lightheadedness or dizziness.

Question 3

The nurse is caring for a patient having a bone marrow biopsy.What nursing action is the most important following the biopsy?

Accepted Answer

Following biopsy,the nurse observes the aspiration site for bleeding and infection.Because bleeding is the most immediately life-threatening,it takes first priority.B.C.Pain control and fluids are also important,but they are not the most immediately life threatening.D.Infection at the site will not occur immediately after the procedure.

Question 4

A patient with abdominal injuries from a motor vehicle crash is scheduled for surgery to remove the spleen.What bodily function will be affected by the removal of this organ?

Accepted Answer

The spleen contains fixed macrophages that phagocytize pathogens and worn or defective blood cells and platelets.A.The kidneys filter waste products.C.The lungs clear mucous in the tracheobronchial tree.D.The pancreas facilitates glucose to be used by the cell for energy.

Question 5

A patient is being prepared to receive a prescribed blood transfusion.What is the best way that the LPN can assist the health team to prevent a transfusion reaction?

Accepted Answer

Correct identification is essential to all blood transfusions.A.B.C.Warming blood,administering diphenhydramine,and frequent vital sign monitoring may be appropriate in specific cases but are not the best way to prevent reactions in most patients.

Question 6

The nurse is monitoring a patient receiving a blood product and is concerned that the blood is going to deteriorate before it is complete infused.What is the maximum time that blood can hang during infusion before it begins to deteriorate?

Accepted Answer

Generally,2 hours is a good time frame to transfuse each unit of packed cells.If it must transfuse more slowly because of the patient's condition,make sure that the unit does not hang longer than 4 hours.After that time,the blood is too warm and begins to deteriorate.A.C.Blood will not deteriorate if hanging for 1 or 3 hours.

Question 7

The nurse is assessing a patient with chronic lung disease.Which finding indicates long-term hypoxia?

Accepted Answer

Clubbed fingertips and raised nail beds may indicate long-term hypoxia which can be caused by anemia.A.B.D.Crackles,dyspnea,and pallor can all indicate respiratory pathology but not necessarily long-term disease.

Question 8

The nurse is staying with a patient who has been started on a blood transfusion.Which assessment should the nurse perform during a blood product infusion to detect a reaction?

Accepted Answer

Changes in vital signs can signal onset of transfusion reaction.B.C.D.Bowel sounds,pupils,and skin turgor are not generally affected with a transfusion reaction.

Question 9

The nurse notes that a patient's gaping wound is developing a blood clot.Which body substance is responsible for this clot formation?

Accepted Answer

Platelets are formed in the red bone marrow.They are fragments of large cells and are involved in all mechanisms of hemostasis: vascular spasm,platelet plugs,and chemical clotting.A.Plasma is not responsible for clot formation.C.D.Red and white blood cells may arrive to a site of injury however are not responsible for clot formation.

Question 10

A nurse is preparing to assist with a bone marrow biopsy.Which anatomical site should the nurse anticipate will be used to obtain the specimen?

Accepted Answer

An accurate bone marrow specimen in an adult can be obtained from the sternum,the spinous processes of the vertebrae,or the anterior or posterior iliac crests.A.B.D.The ribs,humerus,and long bones in the legs are not used for a bone marrow biopsy.

Question 11

A patient receiving blood begins complaining of severe chest pain and a feeling of warmth.What should the nurse do first?

Accepted Answer

The nurse will likely carry out all the actions,but the blood must be discontinued first,to stop the source of the reaction.A.The physician can be notified after the blood is stopped.D.The nurse will continue to measure vital signs and cardiovascular status after the infusion is stopped.B.The nurse will provide medication therapy as prescribed but only after the infusion has been stopped.

Question 12

The nurse is concerned that a patient is demonstrating signs of red blood cell production.What laboratory value did the nurse most likely use to make this decision?

Accepted Answer

The heme unit from RBC destruction forms bilirubin.B.Iron is not a value used to determine red blood cell destruction.C.Thrombin is involved in clotting.D.Intrinsic factor is a chemical produced by the parietal cells of the stomach lining that promote absorption of vitamin B₁₂.

Question 13

A patient is admitted to determine why red blood cells are being quickly destructed in the body.What finding should the nurse associate with this patient's health problem?

Accepted Answer

Red blood cells live for about 120 days and then become fragile and are phagocytized by fixed macrophages in the liver,spleen,and red bone marrow.Red blood cells destroyed sooner can cause jaundice to occur in the patient.B.C.D.Bleeding,diarrhea,and cyanosis are not manifestations associated with red blood cell destruction.

Question 14

A patient receiving blood complains of dyspnea.The nurse auscultates the patient's lungs and finds crackles that were not present before the start of the transfusion.Which type of reaction should the nurse suspect?

Accepted Answer

Crackles and dyspnea indicate fluid in the lungs,a sign of circulatory overload.A.B.C.These are not typical symptoms of anaphylactic,urticarial,or hemolytic reactions.

Question 15

A patient with a bleeding disorder is prescribed an infusion of plasma.What should the nurse explain as being the purpose of this infusion?

Accepted Answer

Plasma is about 91% water.Plasma proteins are synthesized by the liver and include clotting factors,albumin,and globulins.A.Red blood cells carry oxygen to the tissues.C.D.A variety of substances support cellular metabolism and remove waste products from cells.

Question 16

The nurse is documenting findings after completing data collection with a patient.What term should the nurse use to document a large area of discoloration from hemorrhage under the skin?

Accepted Answer

Ecchymoses are large areas of discoloration from hemorrhage under the skin.A.Pallor is paleness.B.Rubor is generalized redness.C.Petechiae are small purplish hemorrhagic spots under the skin.

Question 17

A patient who is taking warfarin (Coumadin)5 mg daily has an international normalized ratio (INR)of 2.5.It is time to administer the next dose of Coumadin.What should the nurse do?

Accepted Answer

The INR therapeutic range is 2 to 3,so 2.5 is where it should be,and the Coumadin can be administered.A,B,and C would be appropriate for an elevated INR.

Question 18

The nurse is explaining the role of red blood cells with oxygen transport in the body with a nursing student.Which term should the nurse use to describe hemoglobin that has given up its oxygen to the body's cells?

Accepted Answer

Once hemoglobin gives up its oxygen to the cells of the body,it becomes reduced hemoglobin.C.Oxyhemoglobin is formed in the pulmonary capillaries where the hemoglobin combines with the oxygen in the lungs.B.D.Detached and hypoxyhemoglobin are not terms used to describe hemoglobin that has released oxygen into body cells.

Question 19

The nurse is reviewing the parts of the complete blood count and differential with a patient.Where should the nurse state that neutrophils,eosinophils,and basophils are produced?

Accepted Answer

The granular white blood cells - neutrophils,eosinophils,and basophils - are produced in the red bone marrow.B.T lymphocytes complete their development in the thymus.A.C.The T lymphocytes and B lymphocytes become activated,proliferate,and differentiate in the lymph nodes,spleen,and lymphatic nodules.

Question 20

A patient has an altered level of T and B cells.The nurse realizes that these cells are members of which cell type?

Accepted Answer

There are two groups of lymphocytes: T cells and B cells.B.Eosinophils are granular white blood cells.A.D.Red blood cells and platelets are not types of white cells.

Quiz 27: Hematologic and Lymphatic System Function,Assessment,and Therapeutic Measures